Mental Health, Social Inclusion and Citizenship Awards

 

Mental Health, Social Inclusion and Citizenship Conference Dr Sev Ozdowski OAM, Human Rights Commissioner and Disability Rights Commissioner Adelaide , 31 August 2005

Acknowledgements

Thank you for the opportunity to speak today. It is honour to be here today to help recognise the people who try to make a difference to some of the most vulnerable and marginalised people in our community.

My warm welcome to you all, and especially to those of you who travelled from overseas and interstate to attend this important conference. My best congratulations to the organising committee - it takes plenty of effort and good planning to organise a conference for over 1000 people.

Allow me to commence by acknowledging the traditional owners of the land on which we meet, and their elders past and present. And many thanks to Uncle Louis O'Brian for the traditional welcome to Kaurna country.

I believe this acknowledgment, which it is my custom to make wherever I go to speak in public, is not only a matter of good manners or correct form. It is an important reminder of one of the elements of our diversity as a nation. The acknowledgment also recognised the unique role the First Australians have played in our culture and history and expresses my hope for Australia fair and just for everyone.

Mental health is not just a social issue it is a human rights issue

It is very appropriate to be having a conference that highlights mental health as a social issue with which we must all accept and understand.

But mental health is not just a social issue; it is an also important rights issue.

Australia has signed and ratified many important human rights treaties, in particular ICESCR and CRC which explicitly recognise the right of everyone to the highest possible mental health care

For example, the International Covenant on Economic Social and Cultural Rights , Article 12, states:

The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.  

The Convention on the Rights of the Child , Article 24, states

States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.

We have also the UN Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care (United Nations General Assembly, 1991) which provides further detail of what it needed to meet these rights in Australia .

Human Rights Commission's activities in the area of mental health

The Human Rights and Equal Opportunity Commission has a proud record of long standing involvement with mental health issues.

In 1993 it produced the Burdekin Report which, in summary form, found that the care and support provided by the Australian health care system at that time contravened the basic human rights of our mentally ill.

More recently I conducted a National Inquiry into Children in Immigration Detention "A last resort" which continued exploration of the mental health themes.

During the inquiry it became painfully obviously that long term detention is associated in some cases with serious deterioration of mental health. However, the most serious finding of the detention inquiry was the failure of DIMIA to implement the recommendations from mental health professionals that certain children and families mental health problems cannot be treated in detention and that they should be released for appropriate treatment.

The recommendation read as follows:

"Furthermore, the Government's failure to implement repeated recommendations by mental health professionals to remove children with their parents from detention amounted to "cruel, inhumane and degrading treatment".

Let me briefly give you one case study from the report to add a little flesh to the dry bones of that 'finding' and I refer now to the case of a 13 year old child who had been seriously mentally ill since May 2002.

This boy had regularly self-harmed . In February 2003 a psychiatrist examining the boy wrote the following:

"When I asked if there was anything I could do to help him, he told me that I could bring a razor or knife so that he could cut himself more effectively than with the plastic knives that are available."

The most disturbing fact is that there had been approximately 20 recommendations from mental health professionals saying that he should be released from detention with his family. Some said that removal from detention was a matter of urgency.

When finally released, (after 3 years detention, and 2 years after mental illness diagnosis) as refugees, following an RRT finding, into the Adelaide community, all members of the family were severely mentally traumatized; prescribed heavy, daily medication, too ill to work and requiring extensive community support and assistance.

In other words, we locked them up, we traumatised them and now as they join the Australian family, we are going to have to pay a price for that treatment.

These findings were further amplified by recent revelations of treatment of two mentally ill women, namely Cornelia Rau and Vivian Solon-Alvares, by DIMIA.

But when we started looking at what sorts of treatment are available, a whole new picture of human rights concerns emerged from the shadows. This in addition ever-increasing concerns expressed to me about mental health services by community members on an ongoing basis throughout my term as Human Rights Commissioner lead to establishment of in mental health consultations with the Mental Health Council of Australia (MHCA) and the Brain and Mind research Institute (BMRI).

Here allow me to mention in particular Dr Grace Groom, former CEO of MHCA who has played a key role in the consultations. At the moment she is recovering from cancer in Brisbane , and we all wish her speedy recovery to health.

Methodology of the mental health consultations

To start with, MHCA and HREOC issued an invitation to all those interested in mental health issues to provide us with written submissions. By now we have received over 360 submissions.

Then we conducted open community forums in each State and Territory from 05 July - 14 October 2004 (approx 20 forums were held; approximately 1,200 people came to talk to us):

• consumers
• carers
• general members of the community
• clinicians
• advocates
• service providers (eg. Mental health, general health, accommodation providers)
• emergency personnel (eg. Police)
• academics and
• administrators.

We also conducted individual meetings with specific community, professional and non-government groups as well as meetings with various members of State and Federal governments.

I am pleased to indicate that our Report " Not for Service " will be launched shortly.

Key points from the consultations

The following are the key points raised with us during the consultations:

• Resources provided are simply inadequate to match the level of unmet needs and ensure access to treatment and services when they are needed. Accountability for money allocated to mental health services is seriously lacking.
• The most frequently mentioned gap in mental health services was the absence of early intervention and other specialist services for young people. All too often people are being told, in effect, to come back when they are really ill. It is a good time to look at prevention and early intervention, rather than face the high cost of the treatment, in the future. As you all know, Australia leads the way in development of early intervention programs for mentally ill. They are being implemented overseas, but not in Australia.
• Despite increasing evidence of links between drug use and mental illness we still lack adequate mental health facilities to cope where a person also has an addiction - or other forms of dual diagnosis.
• In all States I received reports of children and young people being admitted to inappropriate adult facilities.
• Emergency services are overburdened and often inaccessible.
• Acute care services are too often simply missing, especially in regional Australia . This results in preventable death.
• Community supports likewise are seriously overburdened and unable to cope with the existing demand.
• Those with a mental illness are still being blamed for being sick.

These consultations confirm other reports

To be perfectly honest, all the concerns that were mentioned to us are in fact well known for a considerable period of time.

For example, the evaluation of the Second National Mental Health Plan published by the Department of Health and Ageing in March 2003, stated that:

"progress has been constrained by the level of resources available for mental health and by varying commitment to mental health care reform. While the aims of the Second Plan have been an appropriate guide to change, what has been lacking is effective implementation. The failures have not been due to lack of clear and appropriate directions, but rather to failures in investment and commitment."

A shorter way of saying that might be that governments have not sufficiently matched their words with dollars.

Very similar conclusions can be found in the "Out of Hospital Out of Mind" report released by the Mental Health Council of Australia (MHCA) in April 2003 in the lead up to the Third National Mental Health Plan.

To sum up, the failure of adequate funding for mental health services, the failure by governments to address the issue and the resulting human right breaches and suffering of people with mental health problems and their carers are well known for a number of years.

Now it is a time for action. We do not need more inquiries and reports. We need our governments to act and ensure that our mental health services in Australia are up to the first world standard.

To achieve this we need to involve our civil society. We need opinion makers, media, average Australians to publicise the issues associated with mental health shortages. We need new NGOs established and working for a change. The fact that we have got children with their parents out of immigration detention centres is a testimony to the strength of Australian civil society movement.

Time to celebrate

Our consultations on mental health services painted a very depressing picture and it is true that there is a long way to go before Australia 's mentally ill can truly enjoy the highest attainable standard of mental health as the human rights treaties require.

The good news is that we are starting to get statements from political leaders who are placing mental health reform high on their agenda. For example NSW newest Premier Iemma said that the mental health would be a priority in his inaugural speech.

And of course there are the exceptional individuals and organisations that we are honouring today. We need champions to lead the way.

Throughout the consultations we were constantly hearing from mental health professional and carers who constantly go above and beyond the call of duty to make life better for individuals suffering from mental illness.

We shouldn't have to expect this exceptional behaviour, but without these individual and organisations the system simply would not work.

All these people and organisations constitute a backbone of civil society and backbone of further action which need to be undertaken.

It is my pleasure and honour to welcome them on your behalf today and to celebrate with you their achievements.

I congratulate all the awardees and wish them well. Australia and people with mental illness need you.